Citizens Advice response to the Work and Pensions Select Committee inquiry into disability benefit assessments (November 2017)
Summary
Citizens Advice is a charity that provides free, confidential, impartial and independent advice to help people overcome their problems. Last year we helped over 2.6 million people with 6.1 million issues face to face and people visited our website 43 million times. We provide advice over 2,680 locations across England and Wales.
In the past year we have helped an average of 104,000 people each quarter with Personal Independence Payments (PIP) and 81,000 with Employment and Support Allowance (ESA). PIP and ESA are the two largest inquiry areas across Citizens Advice. This gives us a unique insight into the way the two assessment processes are currently working.
Evidence from our clients suggests timeliness and some administration issues have improved. But high appeal success rates support claims from our advisers that reports and decisions are regularly inaccurate. The design and administration of the assessments, evidence collection and decision making process are not consistently effective.
All this is costly to taxpayer. It is stressful, time consuming and drawn out for claimants, and means people do not have security of income, and cannot focus on work where that is relevant.
Assessments - Assessment reports are often contentious. 92% and 81% of advisors report seeing inaccuracies in PIP assessments and Work Capability Assessments (WCAs) respectively. Many advisors cite inaccurate assessment report conclusions ranging from unjustified extrapolations from assessors’ observations to wholly contested versions of events. Clients often tell our advisors that these inaccuracies tend to overstate their capabilities.
Many find the process of evidence collection poor. While applicants broadly understand the purpose of assessments, they are not always sufficiently assisted to navigate the process or understand what evidence they need to provide. Supporting evidence from GPs can be inconsistent; occasionally refused, often expensive and rarely tailored to the assessment descriptors. ‘The continuing widespread misperception that PIP [and WCA] is a medical test rather than an assessment of functional impact’ identified in the Second Independent Review is consistently reported by our clients and advisors.
Advisors tell us that assessments are consistently failing on mental health, as well as less visible and fluctuating conditions. Assessments can be too formulaic to capture the full extent to which a claimant’s condition affects their day-to-day living or capacity for work. They tell us that applicants and even GPs tend to believe that the primary challenge is proving their diagnosis and exploring the consequences that has for their lives and capabilities. Advisors tell us that assessors tend to approach things differently, applying the same questions and exercises for each of 12 or 17 descriptors to every applicant regardless of condition, often without explanation or asking people to describe their conditions and capabilities.
Appeals - For all but a minority of applicants, Mandatory Reconsideration (MR) confirms the initial decision. For claimants who have been wrongly assessed or later have decisions overturned at tribunal, this prolongs an already difficult and stressful process. 85% of PIP cases and 87% of WCAs are unchanged at MR. Our advisors report supporting claimants to collect additional evidence wherever possible, but that this rarely seems to make a difference unless claimants take it to tribunal.
Our offices report that between 60% and 99% of appeals we assist with are successful, often resulting in radically different scores and awards. This is in line with official statistics showing 68% of ESA appeals and 65% of PIP appeals result in a changed award. Tribunals bring a complete change in approach and client experience. Where initial assessments can be rigid, narrow and do not start with an exploration of the applicant's condition, tribunals are holistic, inquisitive, and more open to medical evidence and the applicant's’ testimony. Clients often report feeling that the appeal hearing is the ‘first time they are listened to’. Advisors report very few complaints about tribunals, even where appeals are unsuccessful.
Experience - Applicant experiences are variable. There are people who go through the process without issue and view it positively. For many claimants we support, however, the overwhelming experience is confusing, burdensome, prolonged and stressful.
Waiting times have been reduced, but remain inconsistent. But 44% of advisors still see clients experience waits of more than two weeks for PIP assessment forms, and around for fifths see appeals last more than three months for both benefits. Communications during these waiting times can be sparse, too often restricted to post and occasionally unreliable. Contradictory communications, particularly between what is said to clients in person and what later arrives by post, are often reported. And clients do not adequately understand the evidence requirements or assessment methods.
Assessments themselves can be extremely variable in length (10-70 minutes). Advisors tell us they vary in tone, confuse some clients and are felt to contain questions and exercises that are irrelevant to clients’ conditions. Advisors believe these inconsistencies are largely down to the the varying quality of assessors.
Clients usually don’t understand that many conclusions in assessment reports are drawn from observation, rather than questioning. Many feel that they are simply not listened to and that this results in conclusions they believe to be surprisingly inaccurate.